The Clinical Analysis Of Total Laparoscopic Treatment Of Congenital Biliary Dilatation In Adult Type I

The operation must have been done as early as possible, when patients were diagnosed with congenital biliary dilatation(CBD), to prevent induced cholangitis,pancreatitis, liver extrahepatic bile duct calculus, biliary cirrhosis, cyst rupture and even malignant. Currently, the authority treatments of congenital biliary dilatation(CBD) are cyst excision and Roux-en-Y hepaticojejunostomy. In 1995, an foreign teem reported a treatment of congenital biliary dilatation in children by laparoscopic-assisted, which included cyst excision and Roux-en-Y hepaticojejun-ostomy, and achieved good results. Whereas, the operative treatment in Adults were carried out later, because of long course, difficulty operations and the higher technical requirements for operator.Objective:In order to explore the safety and feasibility in total laparoscopic treatment of congenital biliary dilatation in adults type I, total laparoscopic surgery and traditional laparotomy had been compared by analizing clinical feartures in operation and postoperation.Methods:We reviewd 53 cases of adult patients with type I congenital biliary dilatation,accepted surgical treatment and collected from hepatobiliary surgery in The Second Affiliated Hospital of Nanchang University between October 2010 and March 2014.According to operating modes, we devided them into total laparoscopic surgery Group(group a) and traditional open surgery Group(Group b), which involved 22 patients and 31 patients respectively. Operating time, bleeding volume, postoperative exhaust time, postoperative hospital stay, postoperative complications,postoperative liver fuctigon and postoperative analgesia were compared in this two groups. Chi-square tests were used to contrast the general information of patients,postoperative complications and postoperative analgesia, and t-tests were utilized to contrast operation time, bleeding volume, postoperative exhaust time,hospital stay and postoperative liver fuctigon yet. Statistical analysis was performwith the help of SPSS 22.0, inspection level was α=0.05.Results:1. General condition: There was no significant differences in age, sex and cysts diameters between this two groups.2. Operation: The operation time of total laparoscopic surgery group was longer than traditional open surgery, however, Comparing with group B, group A had the more less bleeding volumn.3. Postoperation: In terms of postoperation exhaust time and hospital stay, the patients of total laparoscopic surgery group are earlier than traditional open surgery group(P<0.05).The quantity of patient who need analgesia and the injury degrees of liver fuction in postoperation were also more less than traditional open surgery group(P<0.05)..There was no statistically significant difference between the two groups in postoperative complications(P>0.05).Conclusion:1. Total laparoscopic treatment of congenital biliary dilatation in adults type I is safe and feasible.2. Although the operating time of total laparoscopic treatment is longer than traditional open surgery, the postoperative recovery of patients, the injury degrees of liver fuction and the degrees of pain are superior than traditional open surgery.